婴幼儿先天白内障的疗效观察

本文总结了145例205眼先天白内障显微手术临床资料.采用显微镜下囊外摘除术.后囊切开术、人工晶体植入术、晶体联合前部玻璃体切除术.术后圆孔圆眼底清晰可见166眼,占81%.近期并发症瞳孔上移14眼,玻璃体疝10眼,后期并发膜性白内障72眼,占35.1%.斜视眼,占15·6%、术后矫正视力0.1以上者91眼,占44.4%.强调显微手术安全、损伤小、增视机会多.对手术适应证、时机、并发症及视力预后等进行了讨论.

Microsurgery for congenital cataract and clinical analysis.

The authors reviewed 145 consecutive cases of congenital cataract (205 eyes)that had undergone mi-crosurgeries including modern extracapsular cataract extraction with or without posterior capsulotomy and / or intraocular lens (IOL ) implantation, pars plana lensectomy combined with anterior vitrectomy etc- The ages of the patients were between 2 months and 20 years and 62% of them (90 cases) were under 5 years old. The results showed that 20/200 or better of visual acuity were achieved in 91 eyes(44. 4%) after surgery. 3 of 4 eyes of IOL implantation had visual acuity above 20/25. The early complications mainly included vitreous hernia (10 eyes, 4. 8%), pupil disformation (14 eyes, 6. 8%) and hyphema (6 eyes, 2. 9%). The late complications mainly included membranous cataract(72 eyes, 35.l%)and strabismus (32 eyes, 15. 6%). The authors emphasized that the microsurgical techniques for congenital cataract treatment were safer with less surgical injuries so that the patients had more opportunities to improve their visual function. The indications, time selection,complications and prognosis of the surgical treatment were discussed.